Provider Demographics
NPI:1578583886
Name:GARDNER-EDGERTON-ANTIOCH USD 231
Entity Type:Organization
Organization Name:GARDNER-EDGERTON-ANTIOCH USD 231
Other - Org Name:UNIFIED SCHOOL DISTRICT NO 231
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-856-2080
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743-0189
Mailing Address - Country:US
Mailing Address - Phone:888-654-8701
Mailing Address - Fax:620-724-7141
Practice Address - Street 1:218 E SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1320
Practice Address - Country:US
Practice Address - Phone:913-856-2080
Practice Address - Fax:913-856-3283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100212060AMedicaid